Jeffrey David Boehme, O.D.
Optometrist in South Park, PA. Individual provider (NPI-1).
NPI number1477540433
StatusActive
Last updated in NPPESNov 15, 2024
Details
- NPI
- 1477540433
- Entity type
- Individual (NPI-1)
- Name
- Jeffrey David Boehme
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 4, 2005
- Certification date
- Nov 15, 2024
- Last updated
- Nov 15, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - OPTOMETRY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | OEG000653 | PA | Yes |
Practice location
6305 Library RdSouth Park, PA 15129-8502
Phone 412-854-4130 · Fax 412-854-8175
Mailing address
418 Hays RdVenetia, PA 15367-1001
Phone 724-941-3404 · Fax 412-655-6513
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